替牙期扁桃体伴腺样体肥大患儿过敏因素与颌面畸形的相关性

Correlation between allergy factors and maxillofacial malformation in children with tonsil and adenoid hypertrophy in denture replacement period

目的研究替牙期扁桃体伴腺样体肥大患儿过敏因素与颌面部畸形的相关性。方法对2018-2021年在山东大学齐鲁医院耳鼻咽喉科住院行扁桃体及腺样体切除术的替牙期(6⁃12岁)儿童207例行过敏原检测,收集患儿一般资料、临床资料及头影测量指标,组间比较采用t检验或非参数检验,相关分析使用Pearson或Spearman相关性分析,过敏原分类间的组间线性趋势采用多项式线性趋势检验。结果男性患儿中,伴有过敏因素与无过敏因素比较,反映上颌骨相对位置的蝶鞍中心(点S),鼻根点(N)及上齿槽座点所构成的角(SNA)及反映下颌骨相对位置的蝶鞍中心(点S),鼻根点(点N)及下齿槽座点(点B)所构成的角(SNB)有统计学差异(P=0.032;P=0.019),而女性患儿中,伴有过敏因素与无过敏因素比较,头影测量指标无明显差异。并且,过敏因素评分与SNA、SNB呈负相关,与其他所测指标无明显相关。并且SNA、SNB均随着过敏原评分的升高而存在线性降低的趋势(线性趋势=0.003;线性趋势=0.015)。结论扁桃体伴腺样体肥大患儿中,伴过敏因素的男性更易发生上颌矢状方向发育不足及下颌后缩,提示过敏是扁桃体伴腺样体肥大男性患儿颌面畸形的危险因素之一。

Objective To study the correlation between allergy factors and maxillofacial malformation in children with tonsil and ad⁃enoid hypertrophy during tooth replacement.Methods A total of 207 children(6⁃12 years old)undergoing tonsillectomy and ade⁃noidectomy from 2018 to 2021 were enrolled.Allergen detection was performed on all children,and general data,clinical data and cephalometric indicators were collected.T⁃test or non⁃parametric test was used for comparison between groups.Spearman correlation analysis was used for correlation analysis,and polynomial linear trend test was used for inter⁃group linear trend test of allergen clas⁃sification.Results There were statistically significant differences in SNA and SNB reflecting maxillary relative position in male children with and without allergic factors(P=0.032;P=0.019)(Table 3).In female children,there was no significant difference in head measurement indexes between those with and without allergic factors.In addition,the score of allergy factors was negatively correlated with SNA and SNB,but had no significant correlation with other indexes.(Table 4)Both SNA and SNB showed a linear decreasing trend with the increase of allergen score(linear trend=0.003;Linear trend=0.015)(FIG.2,FIG.3).Conclusion In children with tonsillar adenoid hypertrophy,males with allergic factors are more likely to develop sagittal underdevelopment of the upper jaw and retraction of the mandibular,suggesting that allergy is one of the risk factors for maxillofacial deformity in male children with tonsillar adenoid hypertrophy.